| NPI | 1083353908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARHIYO IDIFLE Social Worker 320-224-2234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2022-05-31 |
| Last Update Date | 2022-05-31 |